Ophthalmic device

ABSTRACT

An ophthalmic device including a cannula having a cannula distal end, a lumen, and one or more orifices coupled to the lumen is provided. The cannula is configured to deliver a fluid. A sleeve is disposed around the cannula and has a sleeve distal end. A handle is coupled to the sleeve and the cannula, the handle having an actuator. An internal mechanism is coupled to the actuator and configured to retract the sleeve relative to the cannula. The internal mechanism includes a follower fixedly coupled to the sleeve and moveable between distal and proximal positions, and a release member movable between an activated position and a release position. The release member is coupled to the actuator and configured to release a force that urges the follower from the distal position to the proximal position when the release member moves from the activated position to the release position.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of and claims priority toInternational Patent Application No. PCT/US2019/056480, filed Oct. 16,2019, which claims the benefit of priority under 35 U.S.C. § 119 fromU.S. Provisional Application No. 62/750,151, entitled “OPHTHALMICDEVICE,” filed Oct. 24, 2018, the entirety of which are incorporatedherein by reference.

TECHNICAL FIELD

The present disclosure generally relates to medical devices andprocedures, and more particularly, to an ophthalmic device.

BACKGROUND

Glaucoma is a disease resulting from an increase in intraocular eyepressure (IOP). IOP may increase when natural drainage of the eye (e.g.,drainage of the humus of the eye) is prevented, reduced, or otherwiseblocked. Cavities in front of (e.g., on top of) the lens of the eye arefilled with a viscous fluid called aqueous humor. A continuous flow ofaqueous humor through the eye provides nutrition to portions of the eye(e.g., the cornea and the lens) that have no blood vessels. This flow ofaqueous humor also removes waste (e.g., foreign object debris) fromthese tissues. In a healthy eye, a stream of aqueous humor drains out ofthe anterior chamber of the eye through the trabecular meshwork and intoSchlemm's canal as new aqueous humor is secreted by the epithelial cellsof the ciliary body. The drained aqueous humor enters the venous bloodstream from Schlemm's canal and is carried along with the venous bloodleaving the eye. When the natural drainage mechanisms of the eye (e.g.,Schlemm's canal and/or the trabecular meshwork) stop functioningproperly, the IOP begins to increase.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate exemplary aspects of the presentdisclosure and together with the description, serve to explain theprinciples of the disclosure.

FIG. 1 is a perspective view showing an example of an ophthalmic device.

FIGS. 2A-2B are perspective views showing a distal end of an example ofan ophthalmic device that has an inner cannula surrounded by a sleeve.FIG. 2A shows the inner cannula covered by the sleeve and FIG. 2B showsinner cannula protruding from the sleeve.

FIGS. 3A-3B are longitudinal section views showing a retractable sleeveinteracting with ocular tissue. FIG. 3A shows the sleeve in a distalposition and FIG. 3B shows the sleeve in a retracted proximal position.

FIGS. 4A-4B are side views showing examples of sleeves interacting withocular tissue. FIG. 4A shows an example of a sleeve sized to abutagainst a trabecular meshwork over a Schlemm's canal and a more rigidanatomy neighboring the Schlemm's canal. FIG. 4B shows an example of asleeve sized to collapse the trabecular meshwork into the Schlemm'scanal.

FIGS. 5A-5C are various views showing an example of a sleeve that can beincluded in an ophthalmic device. FIG. 5A is a perspective view of thesleeve, FIG. 5B is a top view of the sleeve, and FIG. 5C is a side viewof the sleeve.

FIGS. 6A-6C are various views showing an example of a sleeve that can beincluded in an ophthalmic device. FIG. 6A is a perspective view of thesleeve, FIG. 6B is a top view of the sleeve, and FIG. 6C is a side viewof the sleeve.

FIGS. 7A-7C are various views of an example of a cannula that can beincluded in an ophthalmic device. FIG. 7A is a perspective view ofcannula, FIG. 7B is a top view of the cannula as implemented in FIG. 7A,and FIG. 7C is a side view of cannula as implemented in FIG. 7A.

FIG. 8 is a longitudinal section view showing an example of a sleevethat can be included in an ophthalmic device.

FIGS. 9A-9C are cross-sectional side views showing an example of amechanism that can be configured to retract a sleeve in an ophthalmicdevice. FIG. 9A shows the mechanism in a starting position, FIG. 9Bshows the mechanism in an intermediate position, and FIG. 9C shows themechanism in a released position.

FIGS. 10A-10C are perspective views showing an example of a mechanismthat can be configured to retract a sleeve in an ophthalmic device. FIG.10A shows the mechanism in a starting position, FIG. 10B shows themechanism in an intermediate position, and FIG. 10C shows the mechanismin a released position.

FIGS. 11A-11D are perspective and cross-sectional side views showing anexample of a mechanism that can be configured to retract a sleeve in anophthalmic device. FIGS. 11A and 11B show the mechanism in a startingposition, FIG. 11C shows the mechanism in a released position, and FIG.11D shows the mechanism in a reset position.

FIGS. 12A-12E are perspective, side and cross-sectional side viewsshowing an example of a mechanism that can be configured to retract asleeve in an ophthalmic device. FIGS. 12A-12C show the mechanism in astarting position, and FIGS. 12D-12E show the mechanism in a releasedposition.

FIG. 13 is a longitudinal section view showing an example of anophthalmic device.

FIGS. 14A-14C are cutaway views showing an example of a mechanismconfigured to inject a fluid. FIG. 14A shows a nut and a pump of themechanism with a linkage removed, FIG. 14B shows a linkage in an initialposition, and FIG. 14C shows the linkage in an actuated position.

FIGS. 15A-15B are cutaway views showing an example of an ophthalmicprocedure that can be performed with an ophthalmic device. FIG. 15Ashows the ophthalmic device entering an anterior chamber and FIG. 15Bshows the ophthalmic device injecting a fluid into a Schlemm's canal.

DETAILED DESCRIPTION

The following detailed description is exemplary and explanatory only andis not restrictive of the features, as claimed. As used herein, theterms “comprises,” “comprising,” or other variations thereof, areintended to cover a non-exclusive inclusion such that a process, method,article, or apparatus that comprises a list of elements does not includeonly those elements, but may include other elements not expressly listedor inherent to such a process, method, article, or apparatus.Additionally, the term “exemplary” is used herein in the sense of“example,” rather than “ideal.” As used herein, the terms “about,”“substantially,” and “approximately,” indicate a range of values within+/−5% of a stated value. The term “distal” refers to a portion farthestaway from a user when introducing a device into a subject. By contrast,the term “proximal” refers to a portion closest to the user when placingthe device into the subject.

Embodiments discussed below relate to a medical device, such as anophthalmic device configured for use in the treatment of glaucoma orother eye conditions, and related methods of use. According to someembodiments, the ophthalmic device can have a distal end including acannula. The cannula can include an inner lumen and one or more outfloworifices configured for delivery of viscoelastic fluid or othersubstance into a target site of a patient, such as a Schlemm's canal.

According to some embodiments, a tip of the cannula can include a collardisposed around an outer surface of the cannula. The collar can beconfigured to interact with intraocular tissue in an aqueous outflowpathway of a patient's eye to facilitate positioning of the cannula orfacilitate fluid transfer with respect to the eye. For example, thecollar can include a radially protruding lip that is fixed or movable toa position proximal to the orifices to provide a structure thatfacilitates positioning of the orifices of the cannula within or nearSchlemm's canal.

According to some embodiments, the collar can be implemented as part ofa retractable sleeve. The sleeve can be disposed around the cannula andconfigured to retract relative to the cannula to pull patient tissue viaa suction effect. For example, manipulation of a button or otheractuator component disposed on a handle of the device can be configuredto retract the sleeve to pull a trabecular meshwork over and around thecannula to penetrate the meshwork with the cannula and open up the canalto facilitate fluid delivery therein.

According to some embodiments, a mechanism can be configured to retractthe sleeve or otherwise move a component of the ophthalmic device with arelatively quick and sharp snapping motion. Such a motion can, forexample, facilitate suction of the patient's tissue and penetrationthereof by the cannula. Additionally or alternatively, the mechanism canoperate a pump to inject the fluid or substance through the cannula inconcert with the retraction of the sleeve.

These and other embodiments are discussed below in relation toparticular examples illustrated in FIGS. 1-9B. However, variousmodifications and alternative applications will be appreciated by thoseskilled in the art. Thus, the detailed description provided with respectto these figures as well as the description provided above should not beconstrued as limiting but rather serves to explain various conceptsassociated with this disclosure.

FIG. 1 shows an example of a medical device, and more particularly,shows an example of an ophthalmic device 10. In the example shown, theophthalmic device 10 is configured as a medical instrument or minimallyinvasive surgical instrument configured to interact with ocular tissueto facilitate injection of a substance into a Schlemm's canal or otherintraocular site of an eye of a patient. However, while examples hereinare described with reference to ophthalmic instruments and procedures,it will be appreciated that teachings of the ophthalmic device 10 can bereadily applied to or adapted for any of a variety of other medical andnon-medical applications. These can include, for example, other medicalprocedures involving interactions with patient tissue other than in thepatient's eye, and other non-medical applications involving fluidinjection or transfer.

Referring to FIG. 1, the ophthalmic device 10 can include a handle 12coupled to an ocular component 21. The ocular component 21 is generallyconfigured for interacting with ocular tissue and/or insertion into anintraocular cavity, such as the anterior chamber of an eye of a patient.The ocular component 21 can be configured to facilitate fluid delivery,tissue manipulation, and/or other interactions with the eye of thepatient.

As shown in the example of FIG. 1, the ocular component 21 can includean elongated tubular member protruding from a distal end of the handle12 and defining a central longitudinal axis C. The ocular component 21can have a working length L and a diameter that permits insertion intothe anterior chamber through a corneal incision or other incision on aneye of a patient. The working length L described herein can be definedas the exposed length or distance of the ocular component 21 protrudingfrom the handle 12, extending from the distal end of the handle 12 tothe distal end of the ocular component 21. The working length L can be,for example, in the range of between about 16 millimeters (mm) and 40mm, or more particularly about 18 mm, although it contemplated thatother dimensions outside of these examples may be suitable in variousimplementations. The diameter may vary across the working length L or beconstant throughout the working length L and can be, for example, in therange of about 100 micrometers (μuμ) to 1000 μm, or more particularlyabout 700 μm, although it is contemplated that other dimensions outsideof these example may be suitable in various implementations. As shown inthe example of FIG. 1, the ocular component 21 can be implemented with astraight geometry (defining a straight central axis C), or the ocularcomponent 21 can be implemented with a curved and/or bent geometry.

With continued reference to FIG. 1, the handle 12 can be implemented asa main body of the ophthalmic device 10 and can be configured to bemanipulated by the hand of a user or other operator. For example asshown in FIG. 1, the handle 12 can be implemented as an elongatedtubular member having a distal end and a proximal end opposite to thedistal end. This can, for example, facilitate gripping or manipulationof the handle 12 using a pencil-grip by a surgeon, although it iscontemplated that handle 12 can be implemented with other shapes andconfigurations, such as pistol-shaped arrangements and/or finger loops.An outer surface of the handle 12 can include finger grips 13 having acontoured shape and/or textured surface (e.g., knurled, ribbed, or othersurface textures) to facilitate grasping of the handle 12 by the user.Implementations are also contemplated in which the outer surface of thehandle 12 has a straight non-contoured shape and/or a smooth outersurface.

The handle 12 can include or be coupled to an actuator 38. The actuator38 can be coupled to one or more moving parts of the ophthalmic device10 to provide one or more operative functions that facilitateperformance of an ophthalmic procedure using the device. For example,the actuator 38 can be configured to move one or more parts of theocular component 21 independently of the handle 12 and/or move two ormore moving parts of the ocular component 21 independently of eachother. Additionally or alternatively, the actuator 38 can be configuredto actuate a pump, plunger, and/or squeeze mechanism for fluid transferthrough the ocular component 21. The actuator 38 can, for example, beconfigured to move the part(s) directly or via an internal mechanismdisposed in the handle 12.

In the example shown in FIG. 1, the actuator 38 is implemented as orotherwise includes a mechanical push button disposed on the handle 12and movable between an un-pressed and pressed position. The push buttonis shown disposed on a lateral side of the handle 12 which can, forexample, facilitate actuation by a surgeon or other user using theirthumb and/or index finger when the handle 12 is grasped in the hand ofthe user during a procedure. Additionally or alternatively,implementations are contemplated in which the push button is disposed inother locations, such as a proximal end of the handle, for example.Implementations are also contemplated in which, instead of or inaddition to the push button, the actuator 38 includes a slider, rollerwheel, squeeze bulb, and/or any other suitable mechanism that can bemanipulated by a user or other operator to actuate a moving part of theophthalmic device 10.

FIGS. 2A and 2B are enlarged views showing an example of an ocularcomponent 21 that can be included in the ophthalmic device 10. FIGS. 2Aand 2B show a distal portion 27 of the ocular component 21 as indicatedin FIG. 1.

In the example shown in FIGS. 2A and 2B, the ocular component 21includes a cannula 14 and a sleeve 260 (also sometimes referred toherein as a “sheath”). The sleeve 260 is disposed around the cannula 14and the cannula 14 is disposed within the sleeve 260. The cannula 14 andthe sleeve 260 can, for example, each be implemented as substantiallytubular components in which the cannula 14 is disposed coaxially withthe sleeve 260 and both the cannula 14 and the sleeve 260 are disposedabout the central axis C. The cannula 14 and/or sleeve 260 can, forexample, each have a working length equivalent to the working length Lof the ocular component 21.

The cannula 14 and the sleeve 260 can be configured for relativemovement with respect to each other. For example as shown in FIGS. 2Aand 2B, the cannula 14 and the sleeve 260 can be moveable with respectto each other between a first configuration (shown in FIG. 2A) in whichthe distal end of the cannula 14 is substantially covered or encased bythe sleeve 260, and a second configuration (shown in FIG. 2B) in whichthe distal end of the cannula 14 protrudes distally from the distal endof the sleeve 260. The relative movement can be accomplished by, forexample, retraction of the sleeve 260 in a proximal directionindependently of the cannula 14 and the handle 12, and/or by deploymentof the cannula 14 in a distal direction independently of the sleeve 260and the handle 12. The actuator 38 can be operatively coupled to thecannula 14 and/or sleeve 260 to move the cannula 14 and/or sleeve 260with respect to a fixed component of the handle 12.

The cannula 14 can be configured to transfer a fluid or other substance.For example, the cannula 14 can be configured for injection of aviscoelastic fluid, such as sodium hyaluronate or chondroitin sulfate.Viscoelastic fluid is a highly pliable, gel-like material which helpsprovide enough space for adequate drainage and eye pressure relief byexpanding tissue structures away from one another, to re-open or expanda flow path of aqueous humor. Viscoelastic fluid also may clear anobstructed view by expanding bleeding structures away from one anotherto improve visualization. It is also contemplated that the cannula 14can be utilized to deliver stem cells, medicaments, gases (e.g., SF6 orC3F8), and/or dyes (e.g., trypan blue dye). Injected stem cells, forexample, can initiate growth of healthy tissues within the eye (e.g., todevelop healthy trabecular meshwork to enhance drainage of aqueous humorthere through). Injected dye, for example, can flow through thetrabecular meshwork to enhance visualization of aqueous humor fluid flowto determine which areas, if any, of the trabecular meshwork remainblocked, collapsed, or otherwise impede flow of aqueous humor. Further,while examples are described with respect to the injection ofsubstances, it is contemplated that the cannula 14 can additionally oralternatively be utilized to withdraw substances, such as to withdrawtissue, blood, aqueous humor, or other substances out of a Schlemm'scanal or other part of an eye.

As shown in FIG. 2B, the cannula 14 can be implemented as a bluntmicrocannula having a rounded, unsharpened, or otherwise atraumatic tipat its distal end. While implementations are also contemplated in whichthe cannula 14 is implemented with a sharp needle or traumatic tip atits distal end, the blunt cannula can facilitate penetration of porouspatient tissue, such as a trabecular meshwork, while mitigating risk ofundesired trauma to surrounding tissue.

The cannula 14 can include one or more orifices 32 disposed on a distalportion of the cannula 14, e.g., disposed on or near the cannula distalend. The one or more orifices 32 can provide one or more fluid transferports configured to transfer a fluid or other substance. For example,the one or more orifices 32 can be configured to provide outflow portsfor delivery of a viscoelastic substance to a Schlemm's canal of an eyeof a patient. As shown in the example of FIG. 2B, the one or moreorifices 32 can be disposed on a lateral side of the cannula 14 whichcan provide one or more fluidic channels through a sidewall of thecannula 14 in a direction transverse to the central axis C.Alternatively, other implementations are contemplated in which theorifices are disposed along the central axis C and/or in any other oneor more suitable positions to transfer fluid to and/or from an intendedtarget site. The orifices can each have a diameter of between 30 μm to70 μm, or such as about 50 μm or about 60 μm, although it iscontemplated that other orifice diameters outside of these ranges may besuitably used in various implementations. The cannula 14 may include oneor more grooves 34 disposed on a distal portion of the cannula 14.

As shown for example in FIGS. 2A and 2B, relative movement between thesleeve 260 and the cannula 14 can be configured to selectively cover anduncover one or more of the orifices 32 with the sleeve 260. For example,when in the first configuration shown in FIG. 2A, the distal end of thesleeve 260 can be disposed at a first axial position distal to theorifice(s) 32 so as to cover or surround the orifice(s) 32, and when inthe second configuration shown in FIG. 2B, the distal end of the sleeve260 can be disposed at a second axial position proximal to theorifice(s) 32 so as to expose the orifice(s) 32 outside of the distalend of the sleeve 260.

The ophthalmic device 10 can further include a collar 299 disposed abouta circumference of a tip of the cannula 14 at or near the cannula distalend. For example as shown in FIGS. 2A and 2B, the collar 299 can be anintegral part of the sleeve 260 or otherwise fixedly coupled to thesleeve 260 at the sleeve distal end, in which case collar 299 can movetogether with the sleeve 260 so that the collar 299 and the cannula 14are movable relative to each other. The collar 299 can provide astructure disposed about a circumference of the cannula 14 (e.g., on oraround an outer diameter of the cannula 14) that is configured tointeract with patient tissue so as to facilitate placement of thecannula 14. For example, a face 451 of the collar 299 at the distal endof the collar can be configured to manipulate a trabecular meshworkand/or provide a guiding constraint that abuts the trabecular meshworkand/or other tissue neighboring Schlemm's canal. This guiding constraintmay, for example, facilitate placement of the orifice(s) 32 to a desiredpenetration depth within the canal.

In the example shown in FIGS. 2A and 2B, the collar 299 is included aspart of a distal portion of the sleeve 260. When the sleeve 260 and thecannula 14 are in the second configuration shown in FIG. 2B, the face451 of the collar 299 provides a lip that protrudes radially outwardaway from an outer diameter of the cannula 14. The lip can abut atrabecular meshwork or other tissue neighboring Schlemm's canal so thatthe penetration depth of the cannula 14 is constrained or guided by apredetermined distance between the distal end of the cannula 14 and thelip (or the face 451 or distal end of the collar 299) when the device isin the second configuration.

FIGS. 3A and 3B are longitudinal section views showing a distal portion27 of an example of an ocular component 21 interacting with oculartissue. FIG. 3A shows the sleeve 260 in a distal position, and FIG. 3Bshows the sleeve 260 in a retracted position in which the sleeve 260 isretracted in a proximal direction 99 as shown by the arrow.

As shown in FIGS. 3A and 3B, the collar 299 at the distal end of thesleeve 260 can be configured to contact patient tissue, and the sleeve260 can be configured to retract proximally so as to pull patient tissueover the cannula 14. For example, the sleeve 260 can be configured toretract in a proximal direction 99 using a snapping motion (i.e., asharp and quick motion) so as to create a suction microenvironment overa trabecular meshwork 86 of an eye of a patient when the sleeve 260and/or collar 299 is pressed against the trabecular meshwork 86. Thesleeve 260 via its snapping motion can pull and expand the trabecularmeshwork 86 proximally, which may also serve to expand a Schlemm's canal80 as the trabecular meshwork 86 vaults away from the anterior wall ofthe canal. Concurrently with the pulling of the trabecular meshwork 86,the distal end of the cannula 14 may be left in place so that thetrabecular meshwork 86 passes over the cannula 14 and the cannula 14pierces or penetrates the trabecular meshwork 86, leaving the orifice(s)32 in place inside of the Schlemm's canal 80. When the trabecularmeshwork 86 is pulled and the orifice(s) 32 are positioned in theSchlemm's canal 80, the ophthalmic device 10 may be configured todeliver a substance into the Schlemm's canal 80 via a lumen 95 in thecannula 14 that is fluidly coupled to the orifice(s) 32. The proximalretraction of the sleeve 260 may beneficially serve to expand theSchlemm's canal 80 and/or otherwise facilitate fluid delivery and/ortreatment via penetration by the cannula 14. It is also contemplatedthat the substance may be injected in some implementations by deployingthe cannula 14 distally while the sleeve 260 remains in place, by movingthe cannula 14 proximally or distally together with the sleeve 260,and/or by other techniques.

FIGS. 4A and 4B are longitudinal side views showing examples of thesleeve 260 interacting with ocular tissue. FIG. 4A shows a first exampleof sizing that can be implemented at the distal end of the sleeve 260,and FIG. 4B shows a second example of sizing that can be implemented inthe distal end of the sleeve 260. FIGS. 4A and 4B show trabecularmeshwork 86 and Schlemm's canal 80 as well as other neighboring eyeanatomy, such as a scleral spur 71, ciliary muscle 69, and Schwalbe'sline 67.

As shown in both FIGS. 4A and 4B, a size of a distal end of the sleeve260 (or a size of the face 451 or distal end of the collar 299) can besufficiently small so as to permit the distal end to be inserted in theiridocorneal angle using an ab interno approach (approach from withinthe anterior chamber) to abut against and contact the trabecularmeshwork 86. In the example shown in FIG. 4A, the size of the distal endof the sleeve 260 is made sufficiently large so that the distal end isconfigured to abut against both the trabecular meshwork 86 andneighboring anatomy that is more rigid than the trabecular meshwork 86,such as scleral spur 71, so as to substantially prevent collapse of thetrabecular meshwork 86 within Schlemm's canal 80 when the distal end isadvanced against the trabecular meshwork 86. In the example shown inFIG. 4B, the size of the distal end of the sleeve 260 is madesufficiently small so that the distal end is configured to collapse thetrabecular meshwork 86 within Schlemm's canal 80 when the distal end ispressed against the trabecular meshwork 86, e.g., in a region betweenscleral spur 71 and Schwalbe's line 67. In either example, upon abuttingagainst the trabecular meshwork 86, the distal end may be configured tocreate a full or partial seal against the trabecular meshwork 86 and/orother ocular tissue together with surrounding fluids such as aqueoushumor and/or viscoelastic (e.g., ophthalmic viscoelastic device (OVD)).The ophthalmic device 10 can then be configured to retract the sleeve260 to pull on the trabecular meshwork 86 as described above withrespect to FIGS. 3A and 3B. Further, it is contemplated that the distalend can have an oblong cross sectional shape with a long side sized likethat shown in FIG. 4A and a short side sized like that shown in FIG. 4B.The long side can be configured to contact the rigid anatomy uponadvancement against the trabecular meshwork 86 when the long side isoriented transverse to the direction in which the trabecular meshwork 86extends around the lens of the eye, and the short side can be configuredto collapse the trabecular meshwork 86 in the Schlemm's canal 80 whenthe long side is aligned with the direction in which the trabecularmeshwork 86 extends.

FIGS. 5A-5C are various views of a distal portion of an example ofsleeve 260 including collar 299. FIG. 5A is a perspective view of thesleeve 260, FIG. 5B is a top view of the sleeve 260 as implemented inFIG. 5A, and FIG. 5C is a side view of the sleeve 260 as implemented inFIG. 5A.

As shown for example in FIGS. 5A-5C, the collar 299 (e.g., the face 451)and the distal end of the sleeve 260 can have an oblong cross-sectionalshape (e.g., an oval, an ellipse, a rounded corner rectangle, or otheroblong shape). The oblong shape has a pair of opposing long sides 93 anda pair of opposing short sides 96. The long sides 93 define a long axis85 of the oblong cross-section and the oblong cross-section has a longouter diameter D_(LONG) along the long axis 85. The short sides 96define a short axis 89 of the oblong cross-section and the oblongcross-section has a short outer diameter D_(SHORT) along the short axis89 smaller than the long diameter D_(LONG). As shown for example in FIG.5B, the collar 299 and the distal end of the sleeve 260 can include apair of diverging outer surfaces 79 on opposing sides of the sleeve 260that diverge (or flare radially outward) towards opposing short sides ofthe distal end of the sleeve 260. As shown for example in FIG. 5C, thecollar 299 and the distal end of the sleeve 260 can also include a pairof converging outer surfaces 75 on opposing sides of the sleeve 260 thatconverge (or taper radially inward) towards opposing long sides of thedistal end of the sleeve 260. As a result, the long outer diameterD_(LONG) can be greater than the outer diameter D_(PROX) of a proximalportion of the sleeve 260, while the short outer diameter D_(SHORT) canbe smaller than the outer diameter D_(PROX) of a proximal portion. Thedistal end of the sleeve 260 can be sized to fit within an iridocornealangle (angle formed between the iris and the cornea) to permit thedistal tip to contact or press against the trabecular meshwork and/orscleral spur of an eye, and the above described orientation with flaredconfiguration along the long axis 85 can be useful to, for example,indicate a preferential orientation of the sleeve tip for the surgeon toproperly place the tip to avoid over compressing the trabecular meshworkand/or Schlemm's canal.

The collar 299 and/or the sleeve 260 can further be configured as alight guide to enhance visualization when placed in the eye. Forexample, a light source such as one or more light emitting diode (LEDs)can be disposed in the handle 12 or otherwise positioned on theophthalmic device 10 proximal to the distal end of the sleeve 260. Thelight source can be configured to couple visible light into thesidewalls of the sleeve 260 so that the light propagates through thesidewalls of the sleeve 260 via total internal reflection (TIR) and outof the distal end or distal portion of the sleeve 260 (e.g., out theface 451). Additionally or alternatively, the sleeve 260 can be madetransparent or include one or more transparent windows to facilitatevisualization of the sleeve 260 and/or the cannula 14, although it iscontemplated that the sleeve 260 can be made wholly opaque to visiblelight in other implementations.

FIGS. 6A-6C are various views of a distal portion of an example ofsleeve 260 including collar 299. FIG. 6A is a perspective view of thesleeve 260, FIG. 6B is a top view of the sleeve 260 as implemented inFIG. 6A, and FIG. 6C is a side view of the sleeve 260 as implemented inFIG. 6A. As shown for example in FIGS. 6A-6C, an outer surface of thecollar 299 and outer surface of a distal portion of the sleeve 260 canfurther include grooves 101. The grooves 101 may enhance a suctioneffect when the sleeve 260 and collar 299 are retracted proximally byincreasing a surface area of the outer surface of that contacts fluids,such as OVD or other surrounding fluids that can be disposed in theanterior chamber of the eye. The grooves 101 are shown in FIGS. 6A-6C asa plurality of circumferential grooves that extend around an outercircumference of the sleeve 260 and are disposed in a converging regionof the collar 299 at a distal portion of the sleeve 260, but it iscontemplated that the grooves 101 can be implemented as other types ofsurface area enhancing textures and/or positioned in other locationsalong an axial length of the sleeve.

It is also contemplated, for example as shown in FIGS. 7A-7C, that thecollar 299 can be fixedly coupled to the cannula 14. FIG. 7A is aperspective view of cannula 14, FIG. 7B is a top view of the cannula 14as implemented in FIG. 7A, and FIG. 7C is a side view of cannula 14 asimplemented in FIG. 7A.

In this example, an independently movable sleeve may be omitted from theophthalmic device 10. For example, the collar 299 can be integrallyformed as part of an outer portion of the cannula 14, or the collar 299can be welded or otherwise fixedly attached to the cannula 14 so thatthe collar 299 moves together with the cannula 14. The fixedly coupledcollar 299 can have an oblong cross-sectional shape or any of the otherfeatures described above with respect to the collar 299 when implementedon the sleeve. As shown for example in FIGS. 7A and 7B, a lip can beprovided by a face of the collar 299 and protrude radially outward froma distal portion of cannula 14. The lip can thus provide a structure forinteracting with tissue as described above. As shown for example in FIG.7B, a radial length L_(R) of lip can be approximately equal to an axiallength LA of the protruding portion of the cannula 14, although it iscontemplated that other dimensions may be suitably used. In thisexample, the lip length L_(R) is defined by the distance between theradially outermost surface of the lip and the radially outermost surfaceof the axially protruding section of the cannula 14 from which the lipcan extend. The cannula tip length LA is defined by the axial lengthfrom the lip (or from the face 451 or distal end of the collar 299) tothe distal end of the cannula 14. The cannula 14 may have an increaseddiameter in a portion proximal to the collar 299 than in a portiondistal to the collar 299. This may beneficially enhance rigidity orstructural integrity of the cannula 14 across its working length, whilepermitting the distal end of the cannula 14 to be made sufficientlysmall in diameter for insertion into Schlemm's canal or another suitabletarget site of the patient. It is also contemplated that any of thesedimensions or geometric features described with respect to the fixedcollar shown in FIGS. 7A-7C can be suitably used in implementationswhere the collar is part of the sleeve 260 or otherwise movable withrespect to the cannula 14 and disposed in a second configuration likethat shown in FIG. 2B.

FIG. 8 is a longitudinal section view showing a distal portion of anexample of ocular component 21 that can be included in ophthalmic device10. In the example shown in FIG. 8, the cannula 14 is shown in aprotruding position relative to the sleeve 260 (e.g., in the secondconfiguration like that shown in FIG. 2B). The cannula 14 is composed ofa plurality of segments including a tip segment 151 and a proximal shaftsegment 153. The tip segment 151 can be attached to the proximal shaftsegment 153 by, for example, laser welding or any other suitablefastening mechanism. The tip segment 151 has an inner diameter D_(SMALL)and the proximal shaft 153 has an inner diameter D_(LARGE) that isgreater than the inner diameter D_(SMALL) of the tip segment 151.Accordingly, the lumen 95 extending through the cannula 14 is segmentedto have a proximal portion 163 that is larger in diameter than thedistal portion 161. This can, for example, reduce back pressure in thedevice, although implementations are also contemplated in which thecannula 14 is composed of a single piece or integral construction,and/or in which the lumen 96 has a substantially constant diameterthrough the cannula 14.

FIG. 8 also shows the collar 299 configured as shown in the example ofFIGS. 5A-5C, in which the collar 299 is implemented at the distal end ofthe sleeve 260 so that a distal tip of the sleeve 260 has an oblongcross section with flared diverging outer surfaces 79 on opposing sidesof the sleeve 260. As shown in the example of FIG. 8, the one or moreorifices 32 can include a pair of orifices on opposing sides of thecannula 14 (e.g., oriented approximately 180 degrees apart from oneanother about the circumference of the cannula 14). The pair of opposingorifices can be aligned along the long axis 85 of the distal tip(aligned along the long axis of the oblong cross section of the collar299) so that the orifices 32 face the short sides 96 of the sleevedistal end and face the diverging outer surfaces 79. This can, forexample, allow the flared or diverging surfaces to serve as an indicatorfor bringing the orifices of the cannula 14 into the Schlemm's canalwith an orientation that points the injected fluid towards the directionof extent of the canal. Although shown in an implementation in which thecollar 299 is fixedly coupled to a movable sleeve 260, it is alsocontemplated that this orientation of the orifices 32 can be applied toimplementations in which the collar 299 is fixed to the cannula 14 likein the example of FIGS. 7A-7C.

FIGS. 9A-9C are various views showing an example of an internalmechanism 301 disposed in the ophthalmic device 10 and utilized toretract sleeve 260. The internal mechanism 301 can, for example, bedisposed in an internal volume of the handle 12 and coupled to theactuator 38.

FIG. 9A shows the internal mechanism 301 in an initial loaded state,FIG. 9B shows the internal mechanism 301 in an intermediate state (e.g.,as the actuator 38 is pressed), and FIG. 9C shows the internal mechanism301 in a released state during or after retraction of the sleeve 260.The internal mechanism 301 shown in FIGS. 9A-9C utilizes a cam andfollower system to retract sleeve 260 in a proximal direction relativeto the cannula 14 and relative to the handle 12. More particularly, theinternal mechanism 301 includes a cam 311 (e.g., rocker) coupled to acatch 321 and a slidable spring-loaded follower 331. The follower 331can be fixedly coupled to the sleeve 260 so that the sleeve 260 movestogether with the follower 331. The catch 321 is configured to hold thefollower 331 in a distal position, and the cam 311 is configured to movethe catch 321 to release the follower 331 in the proximal direction. Thecam 311 is coupled to the actuator 38 to permit the cam 311 to be movedor actuated by pressing the actuator 38.

In FIG. 9A, the internal mechanism 301 is shown in an initial state. Inthis state, the follower 331 (and the sleeve 260) are in a distalposition. The catch 321 is in a first position in which it holds thefollower 331 in the distal position by, for example, abutting a proximalsurface 331 a of the follower 331 to prevent or restrict proximalmovement of the follower 331. While the catch 321 is in the firstposition and the follower 331 is in the distal position, a spring 335applies a spring force to the follower 331 in the proximal direction.The spring 335 is shown in FIGS. 9A-9C as an axial compression spring,but it will be appreciated that a variety of other springs can besuitably used. The actuator 38 coupled to the cam 311 is in anun-pressed position (e.g., an upper position) when the internalmechanism 301 is in the initial state. Application of a user force tothe actuator 38 can urge rotational movement of the cam 311 in a firstrotational direction 355 about cam pivot point 343. As the cam 311rotates in the first rotational direction 355, the cam 311 rotatesagainst the catch 321 to urge movement of the catch 321, for example, toflex in a direction 373 away from the first position of the catch andtowards a second position of the catch. The flex (e.g., downwardmovement) of the catch 321 may have to overcome a biasing force of abiasing spring 345.

In FIG. 9B, the internal mechanism 301 is shown in an intermediate stateas the above forces are being applied. As shown in FIG. 9B, a gap 381can be formed between the cam 311 and the follower 331 upon rotation ofthe cam 311 in the first rotational direction 355. For example, as thecam 311 rotates against the catch 321, the catch 321 can continue tohold the follower 331 in a distal position while the cam 311 rotatesaway from the follower 331 in the first rotational direction 355. Thegap 381 can provide a clearance for the follower 331, together with thesleeve 260, to freely move so that potential energy held in the spring335 can cause a quick and sharp snapping motion upon release of thefollower 331 by the catch 321. Further, the downward flex of the catch321 compresses the biasing spring 345 and increases the potential energyheld in the biasing spring 345. Also, the cam 311 may be coupled to atorsion spring 365 and the rotation of the cam 311 in the firstrotational direction 355 causes the potential energy held in the torsionspring 365 to increase.

In FIG. 9C, the internal mechanism 301 is shown in a retracted orretracting state in which the follower 331 is released by the catch 321.As shown in FIG. 9C, upon sufficient rotation of the cam 311 against thecatch 321, the cam 311 can release the follower 331 by, for example,moving the catch 321 to a second position in which the catch 321releases the follower 331 by, for example, removing a restriction withwhich a distal surface 321 a of the catch 321 abuts against the proximalsurface 331 a of the follower 331. Upon release of the follower,potential energy stored in the spring 335 is released to urge proximalmotion of the follower 331 (and thus the sleeve 260) in the proximaldirection. The follower 331 can move freely through the gap 381 to aproximal position until it is stopped by a restriction. For example, theproximal motion of the follower 331 can terminate upon the follower 331abutting the cam 311, upon abutting a stop included in a housing of thehandle 12, and/or upon abutting a stop included on the catch 321. Thesurface that provides a stop for the follower 331 can, for example, berelatively rigid or can include a cushion or energy absorbing member soas to soften an impact and prevent shocks from transmitting through thedevice and to a surgeon's hand.

In FIG. 9C, the catch 321 is shown in a second position (releasedposition). The catch 321 can be biased by the biasing spring 345 to thefirst position (abutting position shown in FIG. 9A) so as to permit theinternal mechanism 301 to be reset to the initial state upon release ofthe actuator 38 by a user. For example, upon release of the actuator 38,a biasing force from the torsion spring 365 may urge rotational movementof the cam 311 in a second rotational direction opposite to the firstrotational direction 355, and the cam 311 may urge the follower 331 inthe distal direction (e.g., the follower 331 may retract) so as to movethe follower 331 from the follower proximal position to the followerdistal position to reload the spring 335. As the follower 331 movesdistally in this manner, the biasing spring 345 urges the catch 321 toreturn to the first position where it abuts the follower 331 to hold thefollower 331 in the distal position. The internal mechanism 301 can thenbe operated again in a similar fashion for one or more repeated sleeve260 retractions.

FIGS. 10A-10C are various views showing an example of an internalmechanism 401 disposed in the ophthalmic device 10 and utilized toretract sleeve 260. The internal mechanism 401 can, for example, bedisposed in an internal volume of the handle 12 and coupled to theactuator 38.

FIG. 10A shows the internal mechanism 401 in an initial loaded state,FIG. 10B shows the internal mechanism 401 in an intermediate state(e.g., as the actuator 38 is pressed), and FIG. 10C shows the internalmechanism 401 in a released state during or after retraction of thesleeve 260. The internal mechanism 401 shown in FIGS. 10A-10C utilizes amagnetic assembly to retract sleeve 260 in a proximal direction relativeto the cannula 14 and relative to the handle 12. More particularly, theinternal mechanism 401 includes a rotatable housing 411 having one ormore magnets 413 disposed within the rotatable housing 411. For example,as shown in FIG. 10A, the rotatable housing 411 has two magnets 413disposed 180 degrees apart. The rotatable housing 411 is configured torotate about the central longitudinal axis C. The internal mechanism 401also includes a slidable housing 415 having one or more magnets 414, 416disposed within the slidable housing 415. For example, as shown in FIG.10A, the slidable housing 415 has four magnets 414, 416 arranged in twosets, one set of magnets 416 configured to attract and one set ofmagnets 414 configure to repel the magnets 413 in the rotatable housing411. Here, each set of magnets 414, 416 is disposed 180 degrees apart.The internal mechanism 401 further includes a slidable follower 431. Thefollower 431 can be fixedly coupled to the sleeve 260 so that the sleeve260 moves together with the follower 431. The slidable housing 415 isconfigured to hold the follower 431 in a distal position, and therotatable housing 411 is configured to align the attracting magnets 416with the magnets 413 to release the follower 431 in the proximaldirection. The rotatable housing 411 is coupled to the actuator 38 topermit the rotatable housing 411 to be moved or actuated by pressing theactuator 38.

In FIG. 10A, the internal mechanism 401 is shown in an initial state. Inthis state, the follower 431 (and the sleeve 260) are in a distalposition. The slidable housing 415 is in a first position in which itholds the follower 431 in the distal position by, for example, engagingthe follower 431 to prevent or restrict proximal movement of thefollower 431. The slidable housing 415 is held in the first positionwhen the rotatable housing 411 is aligned such that the magnets 413 arealigned with the opposing magnets 414, which applies a repelling forceto the slidable housing 415 in the distal direction. The actuator 38coupled to the rotatable housing 411 is in an un-pressed position (e.g.,an upper position) when the internal mechanism 401 is in the initialstate. Application of a user force to the actuator 38 can urgerotational movement of the rotatable housing 411 in a first rotationaldirection 455 about the central longitudinal axis C. As the rotatablehousing 411 rotates in the first rotational direction 455, the magnets413 move out of alignment with the opposing magnets 414 and therepelling force lessens.

In FIG. 10B, the internal mechanism 401 is shown in an intermediatestate as the above forces are being applied. As shown in FIGS. 10A and10B, a gap 481 exists between the rotatable housing 411 and the slidablehousing 415 in the initial and intermediate states. The gap 481 ismaintained by the repelling or opposing force of the magnets 413 and themagnets 414 in the initial state. In the intermediate state, the gap 481will remain the same size once the magnets 413 are moved out ofalignment with the magnets 414 until another force is placed on theslidable housing 415.

In FIG. 10C, the internal mechanism 401 is shown in a retracted state inwhich the slidable housing 415 and the follower 431 have moved in aproximal direction towards the rotatable housing 411. As shown in FIG.10C, upon sufficient rotation of the rotatable housing 411, the magnets413 become aligned with the attracting magnets 416, which causes anattractive force on the slidable housing 415. The slidable housing 415engaged with the follower 431 can move freely through the gap 381 to aproximal position until it is stopped by a restriction. For example, theproximal motion of the follower 431 can terminate upon the follower 431abutting a portion of the rotatable housing 411, upon abutting a stopincluded in a housing of the handle 12, and/or upon the slidable housing415 abutting the rotatable housing 411. The surface that provides a stopfor the follower 431 and/or the slidable housing 415 can, for example,be relatively rigid or can include a cushion or energy absorbing memberso as to soften an impact and prevent shocks from transmitting throughthe device and to a surgeon's hand.

In FIG. 10C, the slidable housing 415 and the rotatable housing 411 areshown in an attracted position. The slidable housing 415 can be urged bythe magnets 414 to opposed position (distal position shown in FIG. 10A)so as to permit the internal mechanism 401 to be reset to the initialstate upon release of the actuator 38 by a user. For example, uponrelease of the actuator 38, a trigger upstroke may urge rotationalmovement of the rotational housing 411 in a second rotational directionopposite to the first rotational direction 455 until the magnets 413 arealigned with the repelling magnets 414. This causes a repelling forcethat moves the slidable housing 415 and the follower 431 from thefollower proximal position to the follower distal position. The slidablehousing 415 moves distally in this manner until the slidable housing 415or the follower 431 abuts a stop, wherein the opposing or repellingforce from the magnets 413, 414 holds the follower 431 in the distalposition. The internal mechanism 401 can then be operated again in asimilar fashion for one or more repeated sleeve 260 retractions.

The internal mechanism 401 may be configured in particular ways. Forexample, the rotatable housing 411 and/or the slidable housing 415 mayhave any number of magnets 413, 414, 416. As another example, therotatable housing 411 may be configured to rotate any desired amount,such as to rotate 45 degrees in the first rotational direction 455 andto rotate back 45 degrees in the second rotational direction.

FIGS. 11A-11D are various views showing an example of an internalmechanism 501 disposed in the ophthalmic device 10 and utilized toretract sleeve 260. The internal mechanism 501 can, for example, bedisposed in an internal volume of the handle 12 and coupled to theactuator 38.

FIGS. 11A and 11B show the internal mechanism 501 in an initial loadedstate, FIG. 11C shows the internal mechanism 501 in an intermediatestate (e.g., as the actuator 38 is pressed), and FIG. 11D shows theinternal mechanism 501 in a reset state after retraction of the sleeve260. The internal mechanism 701 shown in FIGS. 11A-11D utilizes a dowelpin assembly to retract sleeve 260 in a proximal direction relative tothe cannula 14 and relative to the handle 12. More particularly, theinternal mechanism 501 includes an arm 511 (e.g., rotating lever)coupled to a dowel pin 521 and a slidable spring-loaded follower 531.The follower 531 can be fixedly coupled to the sleeve 260 so that thesleeve 260 moves together with the follower 531. The follower 531 mayalways be in contact with the dowel pin 521.

The dowel pin 521 may have two rounded portions 522 and two flatportions 523 (e.g., double D configuration) and may be disposedperpendicularly to the central longitudinal axis C of the sleeve 260.The dowel pin 521 is configured to hold the follower 531 in a distalposition, and the arm 511 is configured to move (e.g., rotate) the dowelpin 521 to release the follower 531 in the proximal direction. The arm511 is coupled to the actuator 38 to permit the arm 511 to be moved oractuated by pressing the actuator 38. A roller bearing 565 may becoupled to the opposite side of the dowel pin 521 as the arm 511. Thecannula 14 may be configured to pass through an opening in the dowel pin521 to prevent the dowel pin 521 from contacting the cannula 14 duringrotation of the dowel pin 521, thus avoiding asymmetric loading thatcould cause jamming of the dowel pin 521. The depth of the dowel pin 521abutting the follower 531 may change from 94 thousandths of an inch to80 thousandths of an inch in 15 degrees of rotation, thus providing fora sleeve 260 retraction of 14 thousandths of an inch.

In FIGS. 11A and 11B, the internal mechanism 501 is shown in an initialstate. In this state, the follower 531 (and the sleeve 260) are in adistal position. The dowel pin 521 is in a first position in which itholds the follower 531 in the distal position by, for example, one ofthe rounded portions 522 abutting a proximal surface 531 a of thefollower 531 to prevent or restrict proximal movement of the follower531. While the dowel pin 521 is in the first position and the follower531 is in the distal position, a preload spring 535 applies a springforce to the follower 531 in the proximal direction. The preload spring535 is shown in FIGS. 11A-11D as an axial compression spring, but itwill be appreciated that a variety of other springs can be suitablyused. The actuator 38 coupled to the arm 511 is in an un-pressedposition (e.g., an upper position) when the internal mechanism 501 is inthe initial state. Application of a user force to the actuator 38 canurge rotational movement of the arm 511 in a first rotational direction555 about pivot point 543. As the arm 511 rotates in the firstrotational direction 555, the arm 511 rotates the dowel pin 521 to urgemovement of the dowel pin 521, for example, to rotate in the firstrotational direction 555.

In FIG. 11C, the internal mechanism 501 is shown in an intermediatestate as the above forces are being applied. When the dowel pin 521rotates so that one of the flat portions 523 begins to contact theproximal surface 531 a of the follower 531, then the force of thepreload spring 535 causes the follower 531 to quickly move (e.g., snap)in the proximal direction, which causes the dowel pin 521 rotate further(e.g., spin) in the first rotational direction 555. The proximalmovement of the follower 531 causes the sleeve 260 to move in theproximal direction, thereby retracting the sleeve 260 from the distalend of the cannula 14.

In FIG. 11D, the internal mechanism 501 is shown in a reset state. Theinternal mechanism 501 is reset when the pressing force on the actuator38 is released (e.g., finger removed from actuator) and a reset spring545 coupled to the actuator 38 causes the actuator 38 to lift back tothe initial position. As the actuator 38 lifts, the arm 511 rotates(e.g., lifts up), thus causing the dowel pin 521 to rotate so that oneof the rounded portions 522 abuts the follower 531. This movement forcesthe follower 531 and the sleeve 260 to move back in the distaldirection, thus resetting the internal mechanism 501 for another cycle.

FIGS. 12A-12E are various views showing an example of an internalmechanism 601 disposed in the ophthalmic device 10 and utilized toretract sleeve 260. The internal mechanism 601 can, for example, bedisposed in an internal volume of the handle 12 and coupled to theactuator 38.

FIGS. 12A-12C show the internal mechanism 601 in an initial loaded stateand FIGS. 12D and 12E show the internal mechanism 601 in a releasedstate (e.g., after the actuator 38 is pressed) during or afterretraction of the sleeve 260. The internal mechanism 601 shown in FIGS.12A-12E utilizes a hills and valleys assembly to retract sleeve 260 in aproximal direction relative to the cannula 14 and relative to the handle12. More particularly, the internal mechanism 601 includes a rotatablehousing 611 having a varied cam surface 612 on a distal end of therotatable housing 611. The varied cam surface 612 may have hill (e.g.,elevated) portions 613 and valley (e.g., recessed) portions 614. Therotatable housing 611 is configured to rotate about the centrallongitudinal axis C. The internal mechanism 601 also includes a slidablehousing 615 having a varied cam surface 616 on a proximal end of theslidable housing 615. The varied cam surface 616 may have hill portions617 and valley portions 618. The internal mechanism 601 further includesa slidable follower 631. The follower 631 can be fixedly coupled to thesleeve 260 so that the sleeve 260 moves together with the follower 631.The slidable housing 615 is configured to hold the follower 631 in adistal position, and the rotatable housing 611 is configured to align ahill portion 613 with a hill portion 617 to move and/or hold thefollower 631 in the proximal direction. The rotatable housing 611 iscoupled to the actuator 38 to permit the rotatable housing 611 to bemoved or actuated by pressing the actuator 38.

In FIGS. 12A-12C, the internal mechanism 601 is shown in an initialstate. In this state, the follower 631 (and the sleeve 260) are in adistal position. The slidable housing 615 is in a first position inwhich it is engaged and pushed against a preload spring 635. In thefirst position, the slidable housing 615 may not be engaged with thefollower 631 and thus may allow proximal movement of the follower 631.The slidable housing 615 is held in the first position when therotatable housing 611 is aligned such that a hill portion 613 is alignedwith a hill portion 617, which holds the slidable housing 615 in thedistal direction. The actuator 38 coupled to the rotatable housing 611is in an un-pressed position (e.g., an upper position) when the internalmechanism 601 is in the initial state. Application of a user force tothe actuator 38 can urge rotational movement of the rotatable housing611 in a first rotational direction 655 about the central longitudinalaxis C, such as by 45 degrees, for example. As the rotatable housing 611rotates in the first rotational direction 655, the hill portion 617moves out of alignment with the opposing hill portion 613 and into thevalley portion 614.

As shown in FIG. 12C, a gap 681 may be disposed between the rotatablehousing 611 and the slidable housing 615 in the initial state. The gap681 is maintained by the opposing hill portions 613, 617 in the initialstate. A gap 691 may also be disposed between an internal surface 625 ofthe slidable housing 615 and a stop 641 of the follower 631. The gaps681, 691 will each remain at its widest in the initial state until theactuator 38 is pressed and the rotatable housing 611 begins to rotate.

In FIGS. 12D and 12E, the internal mechanism 601 is shown in a retractedstate in which the slidable housing 615 and the follower 631 have movedin a proximal direction towards the rotatable housing 611. As shown inFIGS. 12D and 12E, upon rotation of the rotatable housing 611, the hillportion 613 slides down from the hill portion 617 into the valleyportion 618 on the slidable housing 615. Similarly, the hill portion 617of the slidable housing 615 becomes rotatably aligned with the valleyportion 614 of the rotatable housing 611. The slidable housing 615 maymove freely through the gap 681 (e.g., the gap 681 shrinks) until theinternal surface 625 of the slidable housing 615 engages the stop 641 ofthe follower 631 (e.g., the gap 691 is eliminated). The slidable housing615 and the engaged follower 631 may continue to move to a proximalposition due to force from the preload spring 635 until stopped by arestriction. For example, the proximal motion of the follower 631 canterminate upon the hill portions 613, 617 abutting the valley portions614, 618, upon the slidable housing 615 and/or the follower 631 abuttinga stop included in a housing of the handle 12, and/or upon the follower631 compressing a damper spring 645. The surface that provides a stopfor the follower 631 and/or the slidable housing 615 can, for example,be relatively rigid or can include a cushion or energy absorbing member(e.g., damper spring 645) so as to soften an impact and prevent shocksfrom transmitting through the device and to a surgeon's hand.

In the retracted state shown in FIGS. 12D and 12E, the movement of thefollower 631 in the proximal direction causes the sleeve 260 to retractand expose a distal portion of the cannula 14. The actuator 38 can bebiased by a torsion spring 665 to the initial position so as to permitthe internal mechanism 601 to be reset to the initial state upon releaseof the actuator 38 by a user. For example, upon release of the actuator38, a biasing force from the torsion spring 665 may urge rotationalmovement of the rotatable housing 611 in a second rotational directionopposite to the first rotational direction 655, such as back 45 degrees,for example. The hill portions 613, 617 may slide up out of the valleyportions 614, 618 and urge the slidable housing 615 in the distaldirection so as to move the slidable housing 615 from the proximalposition of the release state to the distal position of the initialstate to reload the preload spring 635. As the slidable housing 615moves in the distal direction, the follower 331 moves distally as welldue to the force of the damper spring 645. The force of the damperspring 645 may be such that the stop 641 of the follower 631 bounces offof the internal surface 625 of the slidable housing 615 to create thegap 691. As another example, the follower 631 may be urged in the distaldirection without the stop 641 bouncing off of the internal surface 625(e.g., the slidable housing 615 moves further in the distal directionthan does the follower 631). When the slidable housing 615 is in theinitial position, the internal mechanism 601 can then be operated againin a similar fashion for one or more repeated sleeve 260 retractions.

The internal mechanism 601 may be configured to cause a hammer impacteffect when the actuator 38 is pressed and the preload spring 635 causesthe slidable housing 615 to snap or accelerate through the gap 681 inthe proximal direction. In particular, the snap acceleration of theslidable housing 615 causes the internal surface 625 to impact the stop641 of the follower 631 with force, such as four times a static force,for example. This hammer action allows for a smaller and/or lightertorsion spring 665, which allows for a lower actuation force to pressthe actuator 38. For example, if the momentum hammer force is four timesa static force, then the user can press on the actuator 38 with fourtimes less force. The snap action also generates a velocity of thesleeve 260 as it snaps back in the proximal direction. For example, itmay be desirable that the sleeve 260 moves backward fast enough togenerate a vacuum effect in order to pull tissue back with it. Forexample, the snap action may generate a sleeve tip velocity of 0.3 to0.5 in/sec, such as 0.4 in/sec.

The damper spring 645 may serve multiple functions as well. For example,when the preload spring 635 force is released, the damper spring 645dampens the force of the slidable housing 615 and the follower 631 asthey snap in the proximal direction. In reverse, when the torsion spring665 causes the internal mechanism 601 to reset, the damper spring 645biases the follower 631 in the distal direction.

While the mechanism has been described with respect to implementationsin which the internal mechanism 301, 401, 501, 601 is utilized toretract sleeve 260 (e.g., to pull a trabecular meshwork via a snappingmotion like that described above with respect to the example of FIGS.3A-3B), it will be appreciated that the mechanism may be suitably usedfor other modes of operation. For example, the snapping motion createdby the mechanism can be utilized to snap the cannula 14 and/or sleeve260 proximally and/or distally to create a vibration (e.g., upon impactof the follower 331, 431, 531, 631 against a stop) that facilitatespenetration of the trabecular meshwork without a need for a suctioneffect. Thus, the follower 331, 431, 531, 631 can be fixedly coupled tothe cannula 14 or any other suitable component for which motion isdesired. It will also be appreciated that if the mechanism is employedfor distal motion of the sleeve 260, cannula 14, or any other component,the various parts and operation of the mechanism can be reversed.

FIG. 13 is a longitudinal section view showing an example of ophthalmicdevice 10. FIG. 13 shows an example of a structure for handle 12 and afluid delivery mechanism that can be included in the handle 12 tofacilitate delivery of a substance through the ocular component 21.

As shown in FIG. 13, the handle 12 can include a housing 713 thatencloses and defines an internal volume 717. A lumen 725 (sometimesreferred to herein as “handle lumen”) can be disposed in the handle 12and be fluidly coupled to the lumen 95 (sometimes referred to herein as“cannula lumen”) protruding from the distal end of the handle 12. Thehandle lumen 725 can, for example, extend through the internal volume717 and be configured to deliver fluid to the cannula lumen 95 from afluid source, such as a fluid reservoir disposed within the internalvolume or coupled to the handle externally.

As shown for example in FIG. 13, the handle 12 can include an inlet port731 configured to couple to the fluid source and to receive an inletfluid. The inlet port 731 can, for example, include a luer lockconnector or any other suitable connector configured to connect to aviscoelastic syringe or any other suitable fluid reservoir. The inletport 731 is shown in FIG. 13 disposed on a proximal end of the handle 12so as to provide an inlet channel extending through an opening in aproximal end of the handle housing 713. Additionally or alternatively,the inlet port 731 can be disposed on another location on the handle 12,such as on a lateral sidewall of the handle 12. In the example shown inFIG. 13, the handle 12 holds a reservoir 799 that can be filled with aninitial volume of fluid or other substance via the inlet port 731.

The handle 12 shown in FIG. 13 further includes a pump 811 which can beconfigured to move fluid through the handle lumen 725 and/or through thecannula lumen 95. For example as shown in FIG. 13, the pump 811 caninclude or be coupled to a piston 798 disposed within the internalvolume 717 of the handle 12 and configured to translate in an axialdirection proximally and/or distally. The piston pump can be configuredto move in the distal direction from a proximal pump position to adistal pump position to draw fluid from the inlet port 731 and/or tourge or push fluid out through the distal end of the cannula lumen 95and out through the orifice(s) 32. Thus, the pump 811 can be configuredfor positive and/or negative displacement of fluid. The piston 798 canalso, for example, be reciprocal in the housing and configured to movein a proximal direction, from the distal pump position to the proximalpump position, so as to reset for delivering a subsequent dosage offluid. Alternatively, the piston 798 can be configured to moveincrementally in a distal direction in which each increment of distalmotion corresponds to a dosage of fluid or other substance.

The pump 811 can include or be coupled to a valve 839 which can bedisposed in the fluidic pathway of the handle lumen 725 and be fixedlycoupled to the pump 811 so as to move together with the pump 811. Thevalve 839 can, for example, be implemented as or otherwise include aone-way valve (or “check valve”) that permits fluid motion there throughin a distal direction and restricts fluid motion there through in aproximal direction so as to create suction from the inlet port 731 andto force fluid out of the orifice(s) upon distal motion of the valve 839together with the handle 12. Additionally or alternatively, it will beappreciated that various other types of pumps and/or fluid transfermechanisms can be configured to move the fluid through the ophthalmicdevice 10.

The pump 811 can further be coupled to actuator 38 so as to permitactuation of the pump for delivery of a dosage or amount of fluid uponactuation of the actuator 38. The pump 811 can, for example, be coupledto the same actuator that moves the sleeve 260 or other part of theocular component 21, or the pump 811 can be coupled to a separateactuator from that used to move the ocular component 21. In the exampleshown in FIG. 13, the actuator 38 includes a push button coupled to thepump 811 and configured trigger delivery of a discrete dosage of fluidupon user depression of the push button.

FIGS. 14A-14C are cutaway views of the handle 12 in which the actuator38 is configured to actuate motion of the distal ocular component aswell as the pump 811 in concert with each other. FIG. 14A is a cutawayview showing the internal mechanism with a linkage and cam removed forclarity. FIGS. 14B and 14C are cutaway views showing the internalmechanism with linkage 923 and cam 311 illustrated in an initialposition before button press, and in an actuated position after buttonpress, respectively.

The mechanism shown in FIGS. 14A-14C can be used so that each buttonpress of the actuator 38 is a trigger that causes both retraction of thesleeve 260 (e.g., to pull trabecular meshwork 86 over the cannula 14 asshown in FIGS. 3A-3B) and delivery of a dosage of fluid through thecannula 14 while the sleeve 260 is retracted (e.g., while the trabecularmeshwork 86 is pulled over the cannula 14 and the orifice(s) 32 arepositioned within the Schlemm's canal 80 as shown in FIGS. 3A-3B). Asshown for example in FIG. 14A, the mechanism can include a nut 979coupled to a threaded portion 981 which is included in or fixedlycoupled to the pump 811. The nut 979 can be mated with the threadedportion 981 so that rotation of the nut 979 drives axial motion of thepump 811 (e.g., translation in a distal direction) so as to cause thepump 811 to move fluid through the handle 12.

As shown in FIGS. 14B and 14C, the actuator 38 can be implemented as apush button coupled to the nut 979 via a linkage 723. As shown in FIGS.14B and 14C, the same push button that drives the nut 979 can also becoupled to cam 311 of internal mechanism 301, arm 511, or rotatablehousing 411, 611 directly or via the linkage 923. Upon a user forcedepressing the button from the un-pressed position shown in FIG. 14B tothe pressed position shown in FIG. 14C, the push button can driverotation of cam 311 in the first rotational direction 355 (e.g., toretract sleeve 260) and drive rotation of the nut 979 via the linkage923, so as to move the piston 798 incrementally forward distally to movefluid through the handle 12 via positive displacement. Concurrently, therotation of the cam 311 causes retraction of the sleeve 260 so thesubstance is delivered by the pump 811 while the sleeve 260 is in aretracted proximal position. Similarly, for internal mechanisms 401, 501and 601, the same push button that drives the nut 979 can also becoupled to rotatable housing 411 of internal mechanism 401, arm 511 ofinternal mechanism 601, or rotatable housing 611 of internal mechanism601, directly or via the linkage 923. Upon a user force depressing thebutton from the un-pressed position to the pressed position, the pushbutton can drive rotation of the rotatable housing 411, the arm 511, orthe rotatable housing 611, in the first rotational direction 455, 555,655 (e.g., to retract sleeve 260) and drive rotation of the nut 979 viathe linkage 923, so as to move the piston 798 incrementally forwarddistally to move fluid through the handle 12 via positive displacement.

FIGS. 15A and 15B illustrate an exemplary method of performing anophthalmic procedure using the ophthalmic device 10. The method can beused to deliver a substance (e.g., a fluid or gas) into, e.g., Schlemm'scanal 80 or any other suitable portion of a patient's eye.

As noted above, in a healthy eye, a stream of aqueous humor 82 drainsout of the anterior chamber 84 of the eye, through the trabecularmeshwork 86 and then into Schlemm's canal 80 and distal collectorchannels. The aqueous humor 82 then exits through Schlemm's canal 80into the collector channels and distal venous system. When this flowpath of aqueous humor 82 is interrupted (e.g., due to diseased ordamaged tissue in the trabecular meshwork 86 and/or Schlemm's canal 80),the IOP of an eye may rise, potentially resulting in a variety ofmedical concerns (e.g., glaucoma, loss of vision, optic nerve damage,etc.).

In order to improve the flow path of aqueous humor 82, a medicalprofessional may insert ocular component 21 through an incision 88 madein the anterior chamber 84 and advance the distal end of sleeve 260 ofthe ocular component 21 to the trabecular meshwork 86 so that it abutsagainst or contacts the trabecular meshwork 86. The sleeve 260 (notvisible in FIG. 15B) can then be retracted so that distal end of thecannula 14 including orifice(s) 32 enter the Schlemm's canal 80, asshown in FIG. 15B and as further described above using any of themechanisms or components described herein.

With reference to FIG. 15B, once distal end of cannula 14 is insertedinto Schlemm's canal 80 such that each of the one or more orifices 32 isfully housed within Schlemm's canal 80, the medical professional mayinject a pre-defined dose or amount of fluid or other substance viaactuation as discussed above. After injection of a pre-defined dose oramount of fluid or other substance through orifices 32, this process maybe repeated any appropriate number of times, with the cannula 14 held inthe same position and/or with the cannula 14 moved to one or moredifferent positions to inject fluid in different locations and/or fromdifferent angles. Optionally, after the injection of one or morepre-defined doses of fluid or other substance at a certain locationwithin Schlemm's canal 80, distal end of the cannula 14 may be retractedand repositioned within the eye. In some arrangements, suchrepositioning may occur via withdrawal of cannula 14 from incision 88(e.g., a first incision), and reinsertion through an additionalincision, spaced from the first incision. Additionally or alternatively,such repositioning may include retraction of distal end 30 fromSchlemm's canal 80 and/or trabecular meshwork 86 and then relocationinto a new portion of Schlemm's canal 80 without removal of cannula 14from the first incision 88. In some implementations, fluid may bedelivered into the Schlemm's canal 80 and trabecular meshwork 86simultaneously, causing the Schlemm's canal 80 to open and deliver thefluid into the various layers of the trabecular meshwork 86.

It is to be understood that while the foregoing description describesdevices and methods for injection of a fluid or other substance throughorifices 32, the ophthalmic device 10 described herein may be arrangedfor precision-controlled aspiration of fluid or other substances awayfrom the eye. For example, ophthalmic device 10 may be actuated in areverse manner from that described above to achieve a removal of fluidor other substances from the eye.

One or more embodiments of the subject technology may include anophthalmic device including a cannula having a cannula distal end, alumen, and one or more orifices coupled to the lumen, the cannulaconfigured to deliver a fluid; a sleeve disposed around the cannula andhaving a sleeve distal end; a handle coupled to the sleeve and thecannula, the handle having an actuator; and an internal mechanismcoupled to the actuator and configured to retract the sleeve relative tothe cannula. The internal mechanism may include a follower fixedlycoupled to the sleeve and moveable between distal and proximalpositions; and a release member movable between an activated positionand a release position, the release member coupled to the actuator andconfigured to release a force that urges the follower from the distalposition to the proximal position when the release member moves from theactivated position to the release position.

One or more embodiments of the subject technology may include whereinthe actuator includes a push button positioned on a lateral side of thehandle and moveable from an un-pressed position to a pressed positionupon application of a user force; and upon movement of the push buttonfrom the un-pressed position to the pressed position, the push button isconfigured to urge rotation of the release member in a first rotationaldirection.

One or more embodiments of the subject technology may include a resetspring coupled to the actuator, the reset spring configured to urge thepush button from the pressed position back to the un-pressed position tourge rotation of the release member in a second rotational directionopposite the first rotational direction.

One or more embodiments of the subject technology may include whereinthe cannula comprises a proximal shaft segment and a tip segmentattached to proximal shaft segment; and the one or more orifices aredisposed on the tip segment.

One or more embodiments of the subject technology may include a springcoupled to the follower and configured to apply a spring force to urgethe follower in the proximal direction when the follower is in thedistal position; a catch movable between a first position and a secondposition, the catch configured to hold the follower in the distalposition when the catch is in the first position and to release thefollower when the catch is in the second position; and the releasemember comprising a cam coupled to the catch, the cam configured torotate in a first rotational direction against the catch to urge thecatch from the first position to the second position.

One or more embodiments of the subject technology may include whereinthe cam is further coupled to the follower; the catch is biased towardsthe second position; and upon release of a user force, the catch isconfigured to urge the cam against the follower in a second rotationaldirection opposite to the first rotational direction to urge thefollower to from the proximal position to the distal position.

One or more embodiments of the subject technology may include a slidablehousing having one or more first magnets and one or more second magnets;and the release member comprising a rotatable housing having one or morethird magnets, wherein the slidable housing is configured to hold thefollower in the distal position when the one or more third magnets arealigned with the one or more first magnets, and to urge the follower tothe proximal position when the one or more third magnets are alignedwith the one or more second magnets.

One or more embodiments of the subject technology may include whereintwo first magnets are disposed 180 degrees apart in the slidable housingon a first plane that bisects a central axis of the slidable housing;two second magnets are disposed 180 degrees apart in the slidablehousing on a second plane that bisects a central axis of the slidablehousing; and two third magnets are disposed 180 degrees apart in therotatable housing on a third plane that bisects a central axis of therotatable housing.

One or more embodiments of the subject technology may include whereinthe rotatable housing is configured to align the one or more thirdmagnets with the one or more first magnets when the release member is inthe activated position; and the rotatable housing is configured to alignthe one or more third magnets with the one or more second magnets whenthe release member is in the release position.

One or more embodiments of the subject technology may include a springcoupled to the follower and configured to apply a spring force to urgethe follower in the proximal direction when the follower is in thedistal position; a dowel pin movable between a first position and asecond position, the dowel pin configured to hold the follower in thedistal position when the dowel pin is in the first position and torelease the follower when the dowel pin is in the second position; andthe release member comprising an arm coupled to the dowel pin, the armconfigured to rotate the dowel pin to urge the dowel pin from the firstposition to the second position.

One or more embodiments of the subject technology may include whereinthe dowel pin comprises two rounded portions and two flat portions,wherein one of the rounded portions is configured to abut a proximalsurface of the follower in the first position and one of the flatportions is configured to abut the proximal surface of the follower inthe second position.

One or more embodiments of the subject technology may include whereinthe dowel pin comprises an opening configured to receive the cannula,wherein the opening is configured to prevent the dowel pin fromcontacting the cannula during rotation of the dowel pin.

One or more embodiments of the subject technology may include theinternal mechanism further having a slidable housing having a proximalsurface comprising a first elevated portion and a first recessedportion; and the release member comprising a rotatable housing having adistal surface comprising a second elevated portion and a secondrecessed portion, wherein the slidable housing is configured to allowthe follower to be disposed in the distal position when the firstelevated portion is engaged with the second elevated portion, and tourge the follower to the proximal position when the first and secondelevated portions are engaged with the first and second recessedportions, respectively.

One or more embodiments of the subject technology may include a firstramp portion disposed between the first elevated portion and the firstrecessed portion, wherein the second elevated portion is configured toslide along the first ramp from the first elevated portion to the firstrecessed portion when the rotatable housing is moved from the activatedposition to the release position.

One or more embodiments of the subject technology may include a secondramp portion disposed between the second elevated portion and the secondrecessed portion, wherein the first elevated portion is configured toslide along the second ramp from the second elevated portion to thesecond recessed portion when the rotatable housing is moved from theactivated position to the release position.

One or more embodiments of the subject technology may include theinternal mechanism further having a gap disposed between a distal facingsurface of the follower and a proximal facing surface of the slidablehousing when the follower is disposed in the distal position; and aspring coupled to the slidable housing and configured to apply a springforce to urge the slidable housing in the proximal direction when thefollower is in the distal position, wherein the spring force isconfigured to cause the distal facing surface of the follower toaccelerate through the gap and contact the proximal facing surface ofthe slidable housing with an impact force.

One or more embodiments of the subject technology may include whereinthe spring force is configured to cause the sleeve to move backward at avelocity of 0.3-0.5 in/sec.

One or more embodiments of the subject technology may include a damperspring disposed proximally to the follower, the damper spring configuredto dampen an impact force from the follower when the follower is movedto the proximal position and to bias the follower towards the distalposition when the follower is in the proximal position.

One or more embodiments of the subject technology may include whereinthe rotatable housing is configured to rotate 45 degrees in a firstrotational direction about a central longitudinal axis of the cannulawhen the rotatable housing moves from the activated position to therelease position.

One or more embodiments of the subject technology may include aninternal mechanism for an ophthalmic device, the internal mechanismincluding: a slidable follower configured to be fixedly coupled to asleeve disposed around a cannula, the slidable follower moveable betweendistal and proximal positions along a central longitudinal axis; aslidable housing having a proximal surface comprising a first elevatedportion and a first recessed portion; a rotatable housing having adistal surface comprising a second elevated portion and a secondrecessed portion, the rotatable housing configured to be coupled to anactuator and movable between an activated position and a releaseposition, wherein the first elevated portion is engaged with the secondelevated portion in the activated position and the second elevatedportion is engaged with the first recessed portion in the releaseposition; a gap disposed between a distal facing surface of the followerand a proximal facing surface of the slidable housing when the followeris disposed in the distal position; and a spring coupled to the slidablehousing and configured to apply a spring force to urge the slidablehousing in the proximal direction when the follower is in the distalposition, wherein the spring force is configured to cause the distalfacing surface of the follower to accelerate through the gap and contactthe proximal facing surface of the slidable housing with an impactforce.

One or more embodiments of the subject technology may include anophthalmic device comprising: a cannula having a cannula distal end, alumen, and one or more orifices coupled to the lumen, the cannula beingconfigured to inject a substance into a Schlemm's canal of an eye of apatient; a sleeve disposed around the cannula and having a sleeve distalend, the sleeve distal end being configured to contact a trabecularmeshwork of the eye; and a handle coupled to the sleeve and the cannula,the handle having an actuator configured to retract the sleeve relativeto the cannula to pull the trabecular meshwork over the cannula via asuction force.

One or more embodiments of the subject technology may include wherein anouter surface of the sleeve comprises one or more grooves configured toincrease a surface area of the outer surface.

One or more embodiments of the subject technology may include wherein anouter surface of the sleeve comprises a plurality of circumferentialgrooves.

One or more embodiments of the subject technology may include whereinthe sleeve distal end has an oblong cross section.

One or more embodiments of the subject technology may include wherein:the oblong cross section has a pair of opposing long sides and a pair ofopposing short sides; the sleeve has a first pair of opposing outersurfaces converging towards the pair of opposing long sides; and thesleeve has a second pair of opposing outer surfaces diverging towardsthe pair of opposing short sides.

One or more embodiments of the subject technology may include whereinthe one or more orifices include a pair of opposing orifices facing thepair of opposing short sides.

One or more embodiments of the subject technology may include wherein:the oblong cross section has a long outer diameter and a short outerdiameter; the sleeve has a proximal portion with a proximal outerdiameter; the long outer diameter is greater than the proximal outerdiameter; and the short outer diameter is shorter than the proximalouter diameter.

One or more embodiments of the subject technology may include wherein:the cannula comprises a proximal shaft segment and a tip segmentattached to proximal shaft segment; and the one or more orifices aredisposed on the tip segment.

One or more embodiments of the subject technology may include wherein:the lumen of the cannula has a first portion disposed in the proximalshaft segment and a second portion disposed in the tip segment; and thefirst portion has a greater diameter than the second portion.

One or more embodiments of the subject technology may include a followerfixedly coupled to the sleeve and moveable between a distal position anda proximal position; a spring coupled to the follower and configured toapply a spring force to urge the follower in a proximal direction whenthe follower is in the distal position; a catch movable between a firstposition and a second position, the catch being configured to hold thefollower in the distal position when the catch is in the first positionand release the follower when the catch is in the second position; and acam coupled to the catch, cam being configured to rotate against thecatch to urge the catch from the first position to the second position.

One or more embodiments of the subject technology may include wherein:the actuator includes a push button positioned on a lateral side of thehandle and moveable from an un-pressed position to a pressed positionupon application of a user force; and upon movement of the push buttonfrom the un-pressed position to the pressed position, the push button isconfigured to urge rotation of the cam against the catch in a firstrotational direction.

One or more embodiments of the subject technology may include wherein:the cam is further coupled to the follower; the catch is biased towardsthe second position; and upon release of the user force, the catch isconfigured to urge the cam against the follower in a second rotationaldirection opposite to the first rotational direction to urge thefollower to from the proximal position to the distal position.

One or more embodiments of the subject technology may include whereinupon movement of the push button from the un-pressed position to thepressed position, the push button is further configured to move a pumpto deliver a substance through the one or more orifices.

One or more embodiments of the subject technology may include a nutconfigured to drive the pump in a distal direction, wherein the pushbutton is coupled to the nut via a linkage.

One or more embodiments of the subject technology may include wherein:the handle comprises a handle distal end and a handle proximal end; thecannula and the sleeve protrude from the handle distal end; and thehandle comprises an inlet port fluidly coupled to the lumen.

One or more embodiments of the subject technology may include wherein:the inlet port is disposed on the handle proximal end; the handlecomprises a pump coupled to the actuator; and the actuator is configuredto actuate the pump to urge the substance through the one or moreorifices.

One or more embodiments of the subject technology may include a methodof performing an ophthalmic procedure, the method comprising: insertinga cannula and a sleeve into an anterior chamber of an eye through anincision; advancing a distal end of the sleeve to a trabecular meshworkof the eye; retracting the sleeve relative to the cannula; and pullingthe trabecular meshwork over the cannula via a suction force appliedwith the retracting of the sleeve.

One or more embodiments of the subject technology may include injectinga substance into a Schlemm's canal of the eye through the cannula whenthe trabecular meshwork is pulled over the cannula.

One or more embodiments of the subject technology may include advancingthe distal end of the sleeve against the trabecular meshwork and ascleral spur of the eye, wherein the distal end is sized small enough toenter an iridocorneal angle of the eye and large enough to avoidcollapsing the trabecular meshwork into a Schlemm's canal of the eye.

One or more embodiments of the subject technology may include advancingthe distal end of the sleeve against the trabecular meshwork; andcollapsing the trabecular meshwork into a Schlemm's canal of the eyewith the distal end of the sleeve, wherein the distal end is sized smallenough to enter an iridocorneal angle of the eye and small enough tocollapse the trabecular meshwork into the Schlemm's canal.

One or more embodiments of the subject technology may include anophthalmic device comprising: a cannula having a cannula distal end, alumen, and one or more orifices coupled to the lumen, the cannula beingconfigured to inject a substance into an eye of a patient; a handlecoupled to the cannula and having a handle distal end; and a lipprotruding radially from an outer surface of the cannula andpositionable between the cannula distal end and the handle distal end.

One or more embodiments of the subject technology may include whereinthe lip is fixedly disposed between the cannula distal end and thehandle distal end at an axial location proximal to at least one of theorifices.

One or more embodiments of the subject technology may include wherein:the lip is part of a retractable sleeve configured to move between adistal position and a proximal position; the lip is disposed at an axiallocation distal to at least one of the orifices when in the distalposition; and the lip is disposed at an axial location proximal to theat least one of the orifices when in the proximal position.

While principles of the present disclosure are described herein withreference to illustrative embodiments for particular applications, itshould be understood that the disclosure is not limited thereto. Thosehaving ordinary skill in the art and access to the teachings providedherein will recognize additional modifications, applications,embodiments, and substitution of equivalents all fall within the scopeof the embodiments described herein. Accordingly, the invention is notto be considered as limited by the foregoing description.

A reference to an element in the singular is not intended to mean oneand only one unless specifically so stated, but rather one or more. Forexample, “a” module may refer to one or more modules. An elementproceeded by “a,” “an,” “the,” or “said” does not, without furtherconstraints, preclude the existence of additional same elements.

Headings and subheadings, if any, are used for convenience only and donot limit the invention. The word exemplary is used to mean serving asan example or illustration. To the extent that the term include, have,or the like is used, such term is intended to be inclusive in a mannersimilar to the term comprise as comprise is interpreted when employed asa transitional word in a claim. Relational terms such as first andsecond and the like may be used to distinguish one entity or action fromanother without necessarily requiring or implying any actual suchrelationship or order between such entities or actions.

Phrases such as an aspect, the aspect, another aspect, some aspects, oneor more aspects, an implementation, the implementation, anotherimplementation, some implementations, one or more implementations, anembodiment, the embodiment, another embodiment, some embodiments, one ormore embodiments, a configuration, the configuration, anotherconfiguration, some configurations, one or more configurations, thesubject technology, the disclosure, the present disclosure, othervariations thereof and alike are for convenience and do not imply that adisclosure relating to such phrase(s) is essential to the subjecttechnology or that such disclosure applies to all configurations of thesubject technology. A disclosure relating to such phrase(s) may apply toall configurations, or one or more configurations. A disclosure relatingto such phrase(s) may provide one or more examples. A phrase such as anaspect or some aspects may refer to one or more aspects and vice versa,and this applies similarly to other foregoing phrases.

A phrase “at least one of” preceding a series of items, with the terms“and” or “or” to separate any of the items, modifies the list as awhole, rather than each member of the list. The phrase “at least one of”does not require selection of at least one item; rather, the phraseallows a meaning that includes at least one of any one of the items,and/or at least one of any combination of the items, and/or at least oneof each of the items. By way of example, each of the phrases “at leastone of A, B, and C” or “at least one of A, B, or C” refers to only A,only B, or only C; any combination of A, B, and C; and/or at least oneof each of A, B, and C.

It is understood that the specific order or hierarchy of steps,operations, or processes disclosed is an illustration of exemplaryapproaches. Unless explicitly stated otherwise, it is understood thatthe specific order or hierarchy of steps, operations, or processes maybe performed in different order. Some of the steps, operations, orprocesses may be performed simultaneously. The accompanying methodclaims, if any, present elements of the various steps, operations orprocesses in a sample order, and are not meant to be limited to thespecific order or hierarchy presented. These may be performed in serial,linearly, in parallel or in different order. It should be understoodthat the described instructions, operations, and systems can generallybe integrated together in a single software/hardware product or packagedinto multiple software/hardware products.

In one aspect, a term coupled or the like may refer to being directlycoupled. In another aspect, a term coupled or the like may refer tobeing indirectly coupled.

Terms such as top, bottom, front, rear, side, horizontal, vertical, andthe like refer to an arbitrary frame of reference, rather than to theordinary gravitational frame of reference. Thus, such a term may extendupwardly, downwardly, diagonally, or horizontally in a gravitationalframe of reference.

The disclosure is provided to enable any person skilled in the art topractice the various aspects described herein. In some instances,well-known structures and components are shown in block diagram form inorder to avoid obscuring the concepts of the subject technology. Thedisclosure provides various examples of the subject technology, and thesubject technology is not limited to these examples. Variousmodifications to these aspects will be readily apparent to those skilledin the art, and the principles described herein may be applied to otheraspects.

All structural and functional equivalents to the elements of the variousaspects described throughout the disclosure that are known or later cometo be known to those of ordinary skill in the art are expresslyincorporated herein by reference and are intended to be encompassed bythe claims. Moreover, nothing disclosed herein is intended to bededicated to the public regardless of whether such disclosure isexplicitly recited in the claims. No claim element is to be construedunder the provisions of 35 U.S.C. § 112(f), unless the element isexpressly recited using the phrase “means for” or, in the case of amethod claim, the element is recited using the phrase “step for”.

The title, background, brief description of the drawings, abstract, anddrawings are hereby incorporated into the disclosure and are provided asillustrative examples of the disclosure, not as restrictivedescriptions. It is submitted with the understanding that they will notbe used to limit the scope or meaning of the claims. In addition, in thedetailed description, it can be seen that the description providesillustrative examples and the various features are grouped together invarious implementations for the purpose of streamlining the disclosure.The method of disclosure is not to be interpreted as reflecting anintention that the claimed subject matter requires more features thanare expressly recited in each claim. Rather, as the claims reflect,inventive subject matter lies in less than all features of a singledisclosed configuration or operation. The claims are hereby incorporatedinto the detailed description, with each claim standing on its own as aseparately claimed subject matter.

The claims are not intended to be limited to the aspects describedherein, but are to be accorded the full scope consistent with thelanguage of the claims and to encompass all legal equivalents.Notwithstanding, none of the claims are intended to embrace subjectmatter that fails to satisfy the requirements of the applicable patentlaw, nor should they be interpreted in such a way.

What is claimed is:
 1. An ophthalmic device comprising: a cannula havinga cannula distal end, a lumen, and one or more orifices coupled to thelumen, the cannula configured to deliver a fluid; a sleeve disposedaround the cannula and having a sleeve distal end; a handle coupled tothe sleeve and the cannula, the handle having an actuator; and aninternal mechanism coupled to the actuator and configured to retract thesleeve relative to the cannula, the internal mechanism comprising: afollower fixedly coupled to the sleeve and moveable between distal andproximal positions; a release member movable between an activatedposition and a release position, the release member coupled to theactuator and configured to release a force that urges the follower fromthe distal position to the proximal position when the release membermoves from the activated position to the release position; a slidablehousing having a proximal surface comprising a first elevated portionand a first recessed portion; and the release member comprising arotatable housing having a distal surface comprising a second elevatedportion and a second recessed portion, wherein the slidable housing isconfigured to allow the follower to be disposed in the distal positionwhen the first elevated portion is engaged with the second elevatedportion, and to urge the follower to the proximal position when thefirst and second elevated portions are engaged with the first and secondrecessed portions, respectively; a gap disposed between a distal facingsurface of the follower and a proximal facing surface of the slidablehousing when the follower is disposed in the distal position; and aspring coupled to the slidable housing and configured to apply a springforce to urge the slidable housing in the proximal direction when thefollower is in the distal position, wherein the spring force isconfigured to cause the distal facing surface of the follower toaccelerate through the gap and contact the proximal facing surface ofthe slidable housing with an impact force.
 2. The ophthalmic device ofclaim 1, wherein: the actuator includes a push button positioned on alateral side of the handle and moveable from an un-pressed position to apressed position upon application of a user force; and upon movement ofthe push button from the un-pressed position to the pressed position,the push button is configured to urge rotation of the release member ina first rotational direction.
 3. The ophthalmic device of claim 2,further comprising: a reset spring coupled to the actuator, the resetspring configured to urge the push button from the pressed position backto the un-pressed position to urge rotation of the release member in asecond rotational direction opposite the first rotational direction. 4.The ophthalmic device of claim 1, wherein: the cannula comprises aproximal shaft segment and a tip segment attached to proximal shaftsegment; and the one or more orifices are disposed on the tip segment.5. The ophthalmic device of claim 1, the internal mechanism furthercomprising: a first ramp portion disposed between the first elevatedportion and the first recessed portion, wherein the second elevatedportion is configured to slide along the first ramp from the firstelevated portion to the first recessed portion when the rotatablehousing is moved from the activated position to the release position. 6.The ophthalmic device of claim 5, the internal mechanism furthercomprising: a second ramp portion disposed between the second elevatedportion and the second recessed portion, wherein the first elevatedportion is configured to slide along the second ramp from the secondelevated portion to the second recessed portion when the rotatablehousing is moved from the activated position to the release position. 7.The ophthalmic device of claim 1, wherein the spring force is configuredto cause the sleeve to move backward at a velocity of 0.3-0.5 in/sec. 8.The ophthalmic device of claim 1, the internal mechanism furthercomprising a damper spring disposed proximally to the follower, thedamper spring configured to: dampen an impact force from the followerwhen the follower is moved to the proximal position; and to bias thefollower towards the distal position when the follower is in theproximal position.
 9. The ophthalmic device of claim 1, wherein therotatable housing is configured to rotate 45 degrees in a firstrotational direction about a central longitudinal axis of the cannulawhen the rotatable housing moves from the activated position to therelease position.